Veröffentlichung

Titel:

Sustainability Strategies for Regional Health Information Organization Startups

AutorInnen:

Till Winkler
Pinar Ozturk
Carol V Brown

Kategorie:

Arbeitspapiere

erschienen in:

Health Policy and Technology, 2016

Abstract:

Objectives: Similar to other Western healthcare systems, the U.S. has sought to build a national infrastructure to
enable widespread electronic health information exchange (HIE). The 2009 U.S. HITECH Act’s State HIE
Cooperative Agreement Program (SHIECAP) was a short-term catalyst for bottom-up HIE initiatives by states and
regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our
primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated
sustainability with non-renewable SHIECAP funding in a state environment with very minimal prior HIE activities.

Methods: Based on interview data we collected from 22 stakeholders in New Jersey (NJ) at the state, HIO, and
hospital levels, we apply grounded theory techniques to identify cross-case similarities and differences.

Results: Although the three NJ HIOs that became operational during the SHIECAP grant period faced similar
startup challenges, the two HIOs that demonstrated sustainability pursued distinct technology and sustainability
strategies to develop HIE capabilities to fit their very different regional needs: an HIE capability to improve the
population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare
landscape that rewards care coordination across suburban hospitals and physician practices.

Conclusions: We propose two models of technology and sustainability strategies for developing bottom-up HIE
capabilities for different regional populations. Future research within and beyond U.S. contexts needs to take into
account these key characteristics to improve our understanding of effective policy levers and government funding
mechanisms.

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